Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 049004 | GA |
NPI | 1093800047 |
---|---|
Provider Name | Carlos A Diazgranados |
First Address | Atlanta, GA 30308-2012 |
Second Address | Atlanta, GA 30308-2012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |